U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C23H31Cl2NO3
Molecular Weight 440.403
Optical Activity UNSPECIFIED
Defined Stereocenters 5 / 5
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of ESTRAMUSTINE

SMILES

[H][C@@]12CC[C@H](O)[C@@]1(C)CC[C@]3([H])C4=C(CC[C@@]23[H])C=C(OC(=O)N(CCCl)CCCl)C=C4

InChI

InChIKey=FRPJXPJMRWBBIH-RBRWEJTLSA-N
InChI=1S/C23H31Cl2NO3/c1-23-9-8-18-17-5-3-16(29-22(28)26(12-10-24)13-11-25)14-15(17)2-4-19(18)20(23)6-7-21(23)27/h3,5,14,18-21,27H,2,4,6-13H2,1H3/t18-,19-,20+,21+,23+/m1/s1

HIDE SMILES / InChI

Description
Curator's Comment: Description was created based on several sources, including http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/018045s023lbl.pdf

Estramustine is an antineoplastic agent indicated in the palliative treatment of patients with metastatic and/or progressive carcinoma of the prostate. Estramustine is a combination of estradiol with nitrogen mustard. In vivo, the nitrogen-mustard moiety becomes active and participates in alkylation of DNA or other cellular components. This causes DNA damage in rapidly dividing cancerous cells leading to cell death and ideally, tumor shrinkage. Also, due to the drugs estrogen component, it can bind more selectively to active estrogen receptors. Used for the palliative treatment of patients with metastatic and/or progressive carcinoma of the prostate.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
4.5 µM [IC50]
Target ID: P78559
Gene ID: 4130.0
Gene Symbol: MAP1A
Target Organism: Homo sapiens (Human)
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Palliative
Emcyt

Approved Use

EMCYT Capsules are indicated in the palliative treatment of patients with metastatic and/or progressive carcinoma of the prostate.

Launch Date

6.9413759E11
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
362 ng/mL
140 mg single, oral
dose: 140 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ESTRAMUSTINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: FED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
2.88 μg × h/mL
140 mg single, oral
dose: 140 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ESTRAMUSTINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: FED
972 ng × h/mL
280 mg 3 times / day multiple, oral
dose: 280 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
ESTRAMUSTINE blood
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
13.6 h
140 mg single, oral
dose: 140 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ESTRAMUSTINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: FED
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
50%
ESTRAMUSTINE plasma
Homo sapiens
population: HEALTHY
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
3000 mg/m2 1 times / week multiple, intravenous
Highest studied dose
Dose: 3000 mg/m2, 1 times / week
Route: intravenous
Route: multiple
Dose: 3000 mg/m2, 1 times / week
Sources: Page: p.1118
unhealthy, 66
n = 4
Health Status: unhealthy
Condition: Prostate cancer
Age Group: 66
Sex: M
Population Size: 4
Sources: Page: p.1118
DLT: Malaise and fatigue, Hypotension...
Dose limiting toxicities:
Malaise and fatigue (grade 3, 75%)
Hypotension (grade 3, 25%)
Sources: Page: p.1118
2500 mg/m2 1 times / week multiple, intravenous
MTD
Dose: 2500 mg/m2, 1 times / week
Route: intravenous
Route: multiple
Dose: 2500 mg/m2, 1 times / week
Sources: Page: p.1119, 1124
unhealthy, 66
n = 6
Health Status: unhealthy
Condition: Prostate cancer
Age Group: 66
Sex: M
Population Size: 6
Sources: Page: p.1119, 1124
DLT: Malaise and fatigue...
Dose limiting toxicities:
Malaise and fatigue (grade 3, 40%)
Sources: Page: p.1119, 1124
AEs

AEs

AESignificanceDosePopulation
Hypotension grade 3, 25%
DLT
3000 mg/m2 1 times / week multiple, intravenous
Highest studied dose
Dose: 3000 mg/m2, 1 times / week
Route: intravenous
Route: multiple
Dose: 3000 mg/m2, 1 times / week
Sources: Page: p.1118
unhealthy, 66
n = 4
Health Status: unhealthy
Condition: Prostate cancer
Age Group: 66
Sex: M
Population Size: 4
Sources: Page: p.1118
Malaise and fatigue grade 3, 75%
DLT
3000 mg/m2 1 times / week multiple, intravenous
Highest studied dose
Dose: 3000 mg/m2, 1 times / week
Route: intravenous
Route: multiple
Dose: 3000 mg/m2, 1 times / week
Sources: Page: p.1118
unhealthy, 66
n = 4
Health Status: unhealthy
Condition: Prostate cancer
Age Group: 66
Sex: M
Population Size: 4
Sources: Page: p.1118
Malaise and fatigue grade 3, 40%
DLT
2500 mg/m2 1 times / week multiple, intravenous
MTD
Dose: 2500 mg/m2, 1 times / week
Route: intravenous
Route: multiple
Dose: 2500 mg/m2, 1 times / week
Sources: Page: p.1119, 1124
unhealthy, 66
n = 6
Health Status: unhealthy
Condition: Prostate cancer
Age Group: 66
Sex: M
Population Size: 6
Sources: Page: p.1119, 1124
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG

OverviewOther

Other InhibitorOther SubstrateOther Inducer

Drug as perpetrator​

Drug as perpetrator​

PubMed

PubMed

TitleDatePubMed
Estramustine plus a taxane for advanced prostate cancer: the new standard therapy?
2002
Phase I trial of oral estramustine and 3-hr infusional paclitaxel for the treatment of hormone refractory prostate cancer.
2002
[Second cancer after starting treatment for prostate cancer].
2002 Aug
Ondansetron but not granisetron affect cell volume regulation and potassium ion transport of glioma cells treated with estramustine phosphate.
2002 Aug
Chemotherapy for androgen-independent prostate cancer.
2002 Aug
Editorial: the coming revolution in the treatment of prostate cancer patients.
2002 Aug
Hypertriglyceridemia and pancreatitis associated with estramustine phosphate.
2002 Aug
[Therapy for hormone-refractory prostate cancer].
2002 Dec
[Chemotherapy for prostate cancers].
2002 Dec
Fatal respiratory failure associated with treatment of prostate cancer using docetaxel and estramustine.
2002 Dec
An active regimen of weekly paclitaxel and estramustine in metastatic androgen-independent prostate cancer.
2002 Dec
Editorial: States and state transitions are all that really matter.
2002 Dec
Combination chemotherapy with paclitaxel, estramustine and carboplatin for hormone refractory prostate cancer.
2002 Dec
EMP combination chemotherapy and low-dose monotherapy in advanced prostate cancer.
2002 Feb
Mechanism of action of antitumor drugs that interact with microtubules and tubulin.
2002 Jan
The antimicrotubule drug estramustine but not irradiation induces apoptosis in malignant glioma involving AKT and caspase pathways.
2002 Jan
The role of chemotherapy in advanced prostate cancer.
2002 Jun
Docetaxel in the integrated management of prostate cancer. Current applications and future promise.
2002 Jun
Effects of docetaxel on pain due to metastatic androgen-independent prostate cancer.
2002 Jun
Acute estramustine-induced hypocalcemia unmasking severe vitamin D deficiency.
2002 Jun 1
High activity Rhenium-186 HEDP with autologous peripheral blood stem cell rescue: a phase I study in progressive hormone refractory prostate cancer metastatic to bone.
2002 Jun 5
A phase II Hoosier Oncology Group study of vinorelbine and estramustine phosphate in hormone-refractory prostate cancer.
2002 Mar
Estramustine phosphate enhances the effects of hyperthermia and induces the small heat shock protein HSP27 in the human prostate carcinoma cell line PC-3.
2002 May
Estramustine phosphate combined with orchidectomy as first-line therapy in patients with prostate carcinoma. Effect of age on survival.
2002 May 15
[Hormonal chemotherapy for hormone-refractory prostate cancer].
2002 Nov
Pattern of somatic androgen receptor gene mutations in patients with hormone-refractory prostate cancer.
2002 Nov
Penile metastasis of prostatic adenocarcinoma.
2002 Oct
Drug resistance in prostate cancer cell lines is influenced by androgen dependence and p53 status.
2002 Oct
Combined anti-microtubule therapy: a phase II study of weekly docetaxel plus estramustine in patients with metastatic breast cancer.
2002 Oct
Chemotherapy for prostate cancer.
2002 Sep
Weekly epirubicin in patients with hormone-resistant prostate cancer.
2002 Sep 23
Role of chemotherapy in hormone-refractory prostate cancer. Old issues, recent advances and new perspectives.
2003
[Prostatic cancer in the young adult].
2003 Apr
Neoadjuvant docetaxel and estramustine chemotherapy in high-risk/locallyadvanced prostate cancer.
2003 Apr
A phase II trial of docetaxel and estramustine in patients with refractory metastatic breast carcinoma.
2003 Feb 1
Estimating survival benefit in castrate metastatic prostate cancer: decision making in proceeding to a definitive phase III trial.
2003 Jan
A phase I study of paclitaxel, estramustine phosphate and vinorelbine (Pacl-E-Vin) in advanced malignancies: triple tubulin targeting.
2003 Jan
Bisphosphonate therapy for hormone refractory prostate cancer with bone metastasis.
2003 Jan
Docetaxel (taxotere) in the treatment of prostate cancer.
2003 Jun
The combination of estramustine and mitoxantrone in hormone-refractory prostate cancer: a phase II feasibility study conducted by the Hellenic Cooperative Oncology Group.
2003 Jun
Dose escalation study of intravenous estramustine phosphate in combination with Paclitaxel and Carboplatin in patients with advanced prostate cancer.
2003 Jun
Current strategies in the management of hormone refractory prostate cancer.
2003 Jun
[Malignant priapism as a sign of a recurrent prostate cancer. Differential diagnosis of induratio penis plastica].
2003 Jun
Chemotherapy of prostate cancer: present and future.
2003 Jun
Randomized, multicenter, phase II trial of two multicomponent regimens in androgen-independent prostate cancer.
2003 Mar 1
Activity of docetaxel with or without estramustine phosphate versus mitoxantrone in androgen dependent and independent human prostate cancer xenografts.
2003 May
Physician attitudes toward cytotoxic chemotherapy use in patients with advanced prostate carcinoma.
2003 May 1
Characterization of the MRP4- and MRP5-mediated transport of cyclic nucleotides from intact cells.
2003 May 16
Neoadjuvant therapy before radical prostatectomy in high-risk localized prostate cancer: defining appropriate endpoints.
2003 May-Jun
High-risk localized prostate cancer: primary surgery and adjuvant therapy.
2003 May-Jun
Patents

Sample Use Guides

In Vivo Use Guide
The recommended daily dose is 14 mg per kg of body weight (ie, one 140 mg capsule for each 10 kg or 22 lb of body weight), given in 3 or 4 divided doses. Most patients in studies in the United States have been treated at a dosage range of 10 to 16 mg per kg per day.
Route of Administration: Oral
Estramustine inhibited human endothelial cell proliferation with an IC50 of 4.5 uM and was active at 10-33% of the maximum tolerated dose (MTD) from clinical schedules
Name Type Language
ESTRAMUSTINE
INN   MI   USAN   VANDF   WHO-DD  
USAN   INN  
Official Name English
RO-22-2296/000
Code English
RO 22-2296/000
Code English
NSC-89201
Code English
Estramustine [WHO-DD]
Common Name English
estramustine [INN]
Common Name English
RO-222296000
Code English
RO-22-2296000
Code English
ESTRA-1,3,5(10)-TRIENE-3,17-DIOL, 3-(BIS(2-CHLOROETHYL)CARBAMATE), (17B)-
Common Name English
ESTRAMUSTINE [USAN]
Common Name English
ESTRAMUSTINE [MI]
Common Name English
ESTRAMUSTINE [VANDF]
Common Name English
Estradiol 3-[bis(2-chloroethyl)carbamate]
Common Name English
Classification Tree Code System Code
NDF-RT N0000007246
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
WHO-ATC L01XX11
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
NDF-RT N0000175558
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
LIVERTOX 373
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
NDF-RT N0000007246
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
NCI_THESAURUS C697
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
NCI_THESAURUS C25974
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
NDF-RT N0000007659
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
WHO-VATC QL01XX11
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
NDF-RT N0000000236
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
Code System Code Type Description
EVMPD
SUB07246MIG
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PRIMARY
MESH
D004961
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PRIMARY
MERCK INDEX
m5031
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PRIMARY Merck Index
WIKIPEDIA
ESTRAMUSTINE
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PRIMARY
RXCUI
4089
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PRIMARY RxNorm
CHEBI
4868
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PRIMARY
SMS_ID
100000082381
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PRIMARY
DRUG BANK
DB01196
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PRIMARY
EPA CompTox
DTXSID8046458
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PRIMARY
NCI_THESAURUS
C479
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PRIMARY
ChEMBL
CHEMBL1575
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PRIMARY
PUBCHEM
259331
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PRIMARY
FDA UNII
35LT29625A
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PRIMARY
ECHA (EC/EINECS)
221-076-3
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PRIMARY
CAS
2998-57-4
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
PRIMARY
DRUG CENTRAL
1065
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PRIMARY
INN
2877
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
PRIMARY
NSC
89201
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
PRIMARY
DAILYMED
35LT29625A
Created by admin on Fri Dec 15 15:04:03 UTC 2023 , Edited by admin on Fri Dec 15 15:04:03 UTC 2023
PRIMARY